Can Insurances Deny Sports Injuries?

Most players do not expect to suffer injuries while playing sports. Unfortunately, many sports come with moderate to high risks of player injuries. Common sports injuries range from broken bones to concussions. Some injuries, however, do not stem from the nature of the sport, but someone’s negligence. A lapse in judgment at a high school, for example, could lead to players suffering heatstroke during practice.

If a negligent party causes a sports injury, that party could be financially responsible for the victim’s damages. A claim with the at-fault party’s insurer could result in compensation for economic losses. When insurance companies fight back, however, the victim may struggle to receive fair compensation. In these situations, the victim could benefit from hiring an attorney.

Sports and the Assumption of Risk

Assumption of risk is a legal phrase that refers to participants’ knowledge of the risky nature of an activity. Going skydiving, for example, comes with an assumed risk that the diver could suffer a serious injury or die should the chute fail to deploy. Playing sports comes with certain assumptions of risk for players. Sports that involve player-to-player contact and/or flying objects can come with inherent risks such as impacts and concussions. An insurance company could use the assumption of risk as a defense when disputing liability for a sports injury.

If the injury falls within a player’s reasonable assumption of risk, no one may be financially responsible for the injury. If, however, the injury occurred due to something that no reasonable or prudent player could have anticipated, such as a negligent sports coach or defective equipment, an insurance company could be liable for damages. It may take a lawyer’s assistance to prove that the incident that caused the sports injury does not fall within a reasonable assumption of risk. A lawyer may also be necessary to combat a similar liability waiver defense at a school or gym.

Other Common Defenses to Sports Injury Claims

An insurance company may use other popular defense tactics when trying to avoid paying for a player’s injuries and treatments. Insurance companies often try to use any defense available to get out of offering settlements to injured parties. An insurance claims adjuster may try to convince the claimant to settle for less than the case is worth, or for nothing, during a sports injury claim using common denial tactics.

  • Policy exclusions
  • Missed deadlines
  • Lapse in coverage
  • Expired policy
  • Missing information
  • Treatment delays
  • Preexisting condition
  • Failure to avoid injury

If an insurance company denies your sports injury claim, it must send a valid explanation with its denial letter. The explanation should fit your circumstances or make sense according to your policy. You may need a personal injury lawyer to review your insurance policy to see if the company has given a valid reason for the denial. If the reason does not make sense for your case or the insurance company tried to deny your claim without giving a reason, you may have grounds for a bad faith insurance claim against the company.

How to Handle a Wrongful Insurance Denial

You may be able to convince an insurance company to reevaluate your case and change its answer by filing an appeal. If an appeal fails, your other option for financial recovery could be to file a bad faith insurance claim. A bad faith claim against the insurance company could hold it responsible for denying your claim without a valid reason, resulting in compensation for your damages if you succeed.

You may also have grounds to file a claim against the insurer for breach of contract or negligence. A sports injury attorney near you could help you determine whether you have grounds for a lawsuit against an insurance company for an unfair denial. A lawyer could also help you with your initial sports injury claim against one or more at-fault parties to reduce the risk of receiving a denial in the first place.